Low contrast and radiation dose coronary CT angiography using a 320-row system and a refined contrast injection and timing method
Low contrast and radiation dose coronary CT angiography using a 320-row system and a refined contrast injection and timing method
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DOI：
10.1016/j.jcct.2014.12.002
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发表时间：
2015-01-01
影响因子：
5.4
通讯作者：
Yamashita, Yasuyuki
中科院分区：
文献类型：
--
作者：
Oda, Seitaro;Utsunomiya, Daisuke;Yamashita, Yasuyuki
背景：在CT扫描仪中，320排仪器的特点是光子能量降低，产生强烈的对比增强。因此，可以减少造影剂（CM）剂量。在30排扫描仪上进行的低管电压冠状动脉CT血管造影（CCTA）的结果尚未得到充分评估。目的：我们使用80 kVp管电压、迭代重建（IR）和320排扫描仪评估低对比剂量方案对CCTA图像质量的影响。方法：我们将90例患者（平均体重，56.5 ± 11.0 kg）随机分配至3个CCTA方案中的1个。在方案A下，使用常规120-kVp方案和标准CM剂量（2.80 mg碘/kg体重mgI/kg）扫描30只。另外30例在80 kVp下进行扫描，CM剂量减少25%（210 mgI/kg;方案B）。在方案C下，其余30名患者在80 kVp下扫描，CM剂量减少50%（140 mgI/kg）。对120 kVp和80 kVp图像进行IR处理，对3种方案下获得的图像进行定量和定性分析。结果：方案A、B和C中CM的用量分别为43.6 +/- 10.1、30.3 +/- 4.4和21.0 +/- 4.0 mL。方案B下冠状动脉的平均CT衰减往往高于其他2个方案。方案B的对比噪声比显著更高。方案A和B的平均视觉评分显著高于方案C。平均有效辐射剂量显著低于80 kVp protocol.Conclusion：使用320行扫描仪和我们改进的CM注射和定时方案，在80 kVp CCTA下使用IR减少CM和/或辐射剂量，以获得足够的血管增强在技术上是可行的。（C）2015心血管计算机断层扫描学会。All rights reserved.
Background: Among CT scanners, 320-row instruments feature decreased photon energy and yield strong contrast enhancement. Consequently, the contrast medium (CM) dose can be reduced. The results of low-tube-voltage coronary CT angiography (CCTA) performed on 30-row scanners have not been adequately assessed.Objective: We evaluated the effects of a low-contrast-dose protocol on the image quality of CCTA using 80 kVp tube voltage, iterative reconstruction (IR), and a 320-row scanner.Methods: We randomly assigned 90 patients (mean body weight, 56.5 +/- 11.0 kg) to 1 of 3 CCTA protocols. Under protocol A, 30 were scanned using a conventional 120-kVp protocol and a standard CM dose (2.80 mg iodine/kg body weight mgI/kg]). Another 30 underwent scanning at 80 kVp with a 25% CM dose reduction (210 mgI/kg; protocol B). Under protocol C, the remaining 30 patients were scanned at 80 kVp with a 50% CM dose reduction (140 mgI/kg). The 120 and 80 kVp images were processed with IR. Images obtained under the 3 protocols were subjected to quantitative and qualitative analysis.Results: The amount of CM used in protocol A, B, and C was 43.6 +/- 10.1, 30.3 +/- 4.4, and 21.0 +/- 4.0 mL, respectively. Mean CT attenuation of the coronary arteries tended to be higher under protocol B than the other 2 protocols. The contrast-to-noise ratio was significantly higher under protocol B. The mean visual scores were significantly higher for protocols A and B than protocol C. The mean effective radiation dose was significantly lower under the 80-kVp protocol.Conclusion: With a 320-row scanner and our refined CM injection and timing protocol, it is technically feasible to obtain sufficient vascular enhancement with a reduction in the CM and/or radiation dose at 80-kVp CCTA with IR. (C) 2015 Society of Cardiovascular Computed Tomography. All rights reserved.